Clinical Study of Efficacy of GnRH-α Combined with Add Back Therapy in the Treatment of Endometrosis

Objective To evaluate the effect and safety of gonadotrophin-releasing hormone agonist(GnRH-α) combined with estradiol valerate and medroxyprogesterone acetate in the treatment of endometriosis after conservative laparoscopic operation.Methods Thirty two patients with endometriosis were randomly divided into 2 groups after laparoscopic operation,with 16 patients on the second day of their period in group A receiving 3.75mg triptorelin once every 4 weeks,12 weeks in all and 16 patients on the second day of their period in group B receiving triptorelin and added 1mg CA and 6mg oral medroxy progesterone acetate per day,12 weeks in all.Serum E2,FSH,LH,CA125,visual analogue scale(VAS) of pain and the form of Kupperman were compared in patients before and after treatment.Results(1) After treatment,the levels of FSH,LH,E2 were(2.2±2.1) U/L,(1.70±0.61) U/L,(27.6±6.05)pg/ml in group A and(1.9±1.4) U/L,(1.59±0.74) U/L,(39.5±9.01)pg/ml in group B respectively,and they were significantly lower than those before treatment(P0.05).The level of CA125 was significantly decreased compared with those before GnRH-α treatment(P0.01).(2) Before the treatment,patients VAS scores of A and B group were(5.41±2.92) and(5.64± 3.17) respectively,they were significantly higher than the(2.03±1.92) and(2.45±2.06) after GnRH-α treatment(P0.01),however,no statistically significant difference was found between the two groups after treatment(P0.05).(3) The form of Kupperman after treatment were(14.71±7.63) in group A and(11.13±6.54) in group B,the difference was not statistically significant(P0.05).The incidence of flash and sweat were 93.8% in group A,which was significant higher than the 56.3% in group B(P0.01).Conclusion The add-back therapy that consists of transdermal estradiol and medroxy progesterone acetate is effective and safe in the treatment for endometriosis.